Codeine change will help save lives

06 February, 2018

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Following the unanimous advice of the Advisory Committee on Medicines Scheduling in August 2015, an important change that will help save lives came into effect on February 1 for medicines containing codeine.

Codeine is an opioid drug that can cause opioid tolerance, dependence, toxicity and in high doses, death. Many people also develop severe health issues due to use and misuse of over the counter products containing codeine including liver damage, stomach ulceration, and respiratory depression.

Each year, low dose codeine products are a factor in the death of more than 100 Australians.

And research shows that around half a million Australians are misusing over-the-counter products containing codeine, with many people becoming dependent on it, contributing to serious health complications.

Medicines containing codeine will no longer be available without a prescription – a move that’s based on the best medical advice and has national support from governments, the medical profession and consumer groups.

It is also in line with international best practice with many countries now allowing access to codeine-based products only with a prescription, including the United States of America, Japan, Russia, United Arab Emirates and most of Europe.

Consumers will not be disadvantaged by this change. Most people will be able to get relief from acute pain, and cough, cold and flu symptoms using other safe and effective over-the-counter medicines without codeine.

In fact, Australia’s peak medical groups advise that medicines that contain both ibuprofen and paracetamol provide relief from acute pain as effectively as low dose codeine products, without risk of dependence.

As always, you should visit your doctor if you have unexplained or ongoing pain.

The scheduling of codeine has been the subject of consideration by Government expert committees and the Therapeutic Goods Administration since 2008.

In August 2015, the Advisory Committee on Medicines Scheduling first made the unanimous decision to make codeine prescription only.

This expert committee is comprised of State and Territory Senior Pharmacists as well as independent pharmacists, medical officers and industry experts.

This decision was then subject to a period of consumer and industry consultation.

In March 2016, the Advisory Committee on the Safety of Medicines and the Advisory Committee on Medicines Scheduling both reaffirmed the original decision to make codeine prescription only.

Following the development of a Regulation Impact Statement the decision to make codeine prescription only was reaffirmed in December 2016 for commencement in February 2018.

The change was unanimously supported by all state and territory Chief Pharmacists and Chief Health Officers.

It also has the support of all of Australia’s top medical professionals and consumer groups, including:

The Australian Medical Association

The Royal Australian College of General Practitioners

The Royal Australian College of Physicians

Painaustralia

The Australian and New Zealand College of Anaesthetists

The Australian College of Rural and Remote Medicine

The Rural Doctors Association of Australia

Consumers Health Forum of Australia

Faculty of Pain Medicine

The Turnbull Government has rolled out an extensive communication campaign to ensure health professionals and consumers dealing with chronic and acute pain issues understand what alternatives to codeine are available from 1 February.

The communication campaign commenced in December 2016 and intensified in recent months ahead of the February 1 2018 implementation date.

Codeine products will remain available on doctors’ advice with a prescription, but reducing their use is important as part of our overall strategy to address opioid misuse and abuse in Australia.

The Turnbull Government is also providing $20 million for the Pain MedsCheck trial program which starts 1 February.

People suffering from chronic pain for three months or more will be eligible for a free evaluation of their medicine and pain management by a community pharmacist.

The Pain MedsCheck trial will be managed by the Pharmacy Guild of Australia, in partnership with the Pharmaceutical Society of Australia.